title: Bedside immunochromatographic test for enterovirus 71 infection in children.
abstract: BACKGROUND
  Enterovirus 71 (EV71) causes frequent outbreaks worldwide, particularly in the Asia-Pacific area. Its quick spread is a critical challenge for public health and timely preventive measures and clinical management therefore rely on early detection. There is a need for a rapid, easy-to-use, and reliable method for detecting EV71 infections.
  
  
  OBJECTIVE
  The study aimed to evaluate a bedside immunochromatography (ICT) kit for diagnosing acute EV71 infection in children.
  
  
  METHODS
  Pediatric patients with herpangina or hand-foot-mouth disease were randomly and prospectively enrolled from hospitals across Taiwan. Throat or rectal swabs were collected for viral culture and reverse-transcriptase polymerase chain reaction (RTPCR). For the ICT kit, whole blood was obtained by ear piercing, finger-sticking, or venipuncture. The results of ICT, virus isolation and RTPCR in clinical samples were compared.
  
  
  RESULTS
  Of the 156 patients enrolled, 91 (58%), 64 (41%) and 72 (46%) had positive results of the ICT kit, viral culture and RTPCR, respectively. Laboratory-confirmed infection with either positive EV71 culture or RTPCR was used as the diagnostic standard. The sensitivity and specificity of the ICT kit was 84% and 77%, respectively. The viral culture and RTPCR had relatively lower sensitivity but higher specificity. The patient's age did not affect the performance of the ICT, viral culture and RTPCR. However, a low sensitivity of ICT kit was noted before the second day of disease onset.
  
  
  CONCLUSIONS
  The ICT kit may serve as a simple, quick and reliable method for the bedside diagnosis of acute EV71 infection in children.
authors.affiliation: Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Kuan-Ying Arthur
authors.initials: KY
authors.lastname: Huang
authors.forename: Shuan
authors.initials: S
authors.lastname: Yang
authors.forename: Kuo-Chien
authors.initials: KC
authors.lastname: Tsao
authors.forename: Chih-Jung
authors.initials: CJ
authors.lastname: Chen
authors.forename: Yu-Chia
authors.initials: YC
authors.lastname: Hsieh
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
authors.forename: Juo-Yu
authors.initials: JY
authors.lastname: Hsieh
authors.forename: Jyh-Yuan
authors.initials: JY
authors.lastname: Yang
authors.forename: Yhu-Chering
authors.initials: YC
authors.lastname: Huang
mesh_terms: D001769:Blood / Q000821:virology; D002648:Child; D002675:Child, Preschool; D002846:Chromatography, Affinity / Q000379:methods*; D029821:Enterovirus A, Human / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010614:Pharynx / Q000821:virology; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012007:Rectum / Q000821:virology; D012680:Sensitivity and Specificity; D013624:Taiwan
keywords: Children; Enterovirus 71; Immunochromatographic test